faezeh mashhadi

Malnutrition is a global health issue affecting nearly 40% of the population. Hospital malnutrition is a severe medical problem, which is often overlooked and has negative effects on both patients' health and the economy. In addition, malnutrition increases the risk of clinical complications and mortality. On Nutrition Day (nDay), patients in hospital wards and nursing homes worldwide participate in a cross-sectional survey using a standard questionnaire to assess their nutritional status. This study aimed to investigate the prevalence of malnutrition among patients at Imam Reza Teaching Hospital from 2019 to 2021. 

This study analyzed nDay data from Mashhad’s Imam Reza Teaching Hospital from 2019 to 2021. The study included demographic and nutritional data from patients in fourteen different wards/units of the hospital. Over the past three years, an overview of malnutrition trends was presented by examining patient-reported responses to questions about malnutrition and its risk factors. 

The frequency of malnutrition in Burn units was the highest at 37.5% in the male unit in 2020 (P-value: <0.0001). The lowest BMI was observed in Oncology patients, averaging 18.9±2.4 in 2019. The most significant decrease in nutritional intake occurred in the Gastroenterology department, at 37.5% in 2019. The most significant change in hospital nutrition intake one week before admission was in the General Surgery ward, with a 47.4% decrease in 2019. 

The significance of malnutrition, particularly in hospitals, could assist the health system in addressing this issue by using nDay as a standard questionnaire and screening tool. This study indicated that Burn units, Gastroenterology, Oncology, and General Surgery departments are the most susceptible to malnutrition and thus require increased attention.

Malnutrition, as defined by the World Health Organization (WHO), occurs when the body does not receive sufficient nutrients or energy to meet growth, maintenance, and functional needs. Severe malnutrition in children increases the risk of death, disease episodes, complications, and prolonged illnesses. Therefore, early nutritional support is crucial in pediatric critical care settings. In cases where oral feeding is not feasible, enteral feeding (EN) becomes necessary to provide adequate energy. However, despite its advantages, feeding intolerance remains a significant challenge. This study aims to determine the prevalence of feeding intolerance among critically ill children in the Pediatric Intensive Care Unit (PICU).  This cross-sectional study was conducted at the Akbar Pediatric Subspecialty Center's PICU in Mashhad, Iran between March and April 2022. The evaluation focused on nutritional adequacy and feeding intolerance.  A total of 72 patients were included in this study with a majority being girls. Approximately 30 percent of patients exhibited severe malnutrition based on their BMI Z-score (<-3). Boys were more affected than girls in this regard. Most patients received a combination of EN and parenteral nutrition (PN) to fulfill their energy and protein requirements successfully. In most cases, children consumed over 66% of their energy needs through these methods. Feeding intolerance primarily manifested as vomiting and regurgitation (47%), followed by high gastric residual volume (GRV) (36.1%) and abdominal distention (34.7%).  The findings from our study highlight the prevalence of malnutrition within PICU settings along with common complications associated with feeding intolerance such as vomiting and regurgitation. Standardizing a definition for feeding intolerance could prove beneficial for improving research protocols aimed at effectively managing this condition.

Polycystic ovary syndrome (PCOS) is the most common endocrinological disorder in women of reproductive age. Several studies have shown that inflammation factors have a crucial role in the function of the ovary as ovarian dysfunction can be caused by an imbalance of pro-inflammatory cytokines. Other studies have shown that PCOS patients have high levels of pro-inflammatory cytokines such as tumor necrosis factor-alpha (TNF-α), c-reactive protein (CRP(, interleukin-6 )IL-6(, and interleukin-8 (IL-8). Inflammation can be caused by a variety of factors including diet, and diet-induced inflammation can contribute to insulin resistance and atherogenesis as well as ovulation problems in women with PCOS. It is possible to calculate the components of diet and inflammation caused by diet using many different indices. The Healthy Eating Index (HEI) and Dietary Inflammatory Index (DII) are relatively new indices. As HEI is the overall health index for diet and DII indicates the inflammatory index of the diet, it is possible that a person’s diet can be generally healthy but has a high risk of inflammation, so these two indices should be considered together. Furthermore, dietary management of PCOS patients can reduce hyperinsulinemia, hyperandrogenism, and inflammation, which in turn helps to control and reduce disease complications such as infertility.